The Diaphragm
Average Failure Rate: 16%
The diaphragm is woman-controlled contraceptive device that covers the cervix. It consists of a soft rubber or latex cup that is fitted for size by your doctor. Spermicide is applied to the diaphragm, which is inserted into the vagina; it covers the cervix and is held securely in place behind the pubic bone and rear wall of the vagina. See placement diagram...
How the Diaphragm Works
The diaphragm acts as a barrier to sperm to prevent fertilization, and it holds in place spermicide, which kills any sperm that might slip around the edge of the diaphragm.
Using the Diaphragm
The diaphragm should be left in place for at least six hours after intercourse but no more than 24 hours. If intercourse is repeated, contraceptive cream or jelly should be applied each time. This is inserted with a special applicator while the diaphragm is still in place. As with the condom, never use oils or lubricants which are not listed as safe for use with latex because these can damage the diaphragm, making it less effective. Each time the diaphragm is used you should check it for holes or tears, then have it replaced every two years. The diaphragm's size should be checked by your doctor annually, after a pregnancy, and after a gain or loss of more than ten pounds. Consider this method of contraception only if you are committed to following the procedures for using it properly, as proper placement is essential.
Side-Effects and Health Risks of the Diaphragm
The diaphragm has few health risks and side effects. The most serious risk is toxic shock syndrome, which is why the diaphragm should not be left in place for more than 24 hours. The diaphragm can help prevent certain reproductive tract infections, such as gonorrhea, trichomonisis, chlamydia, cervical neoplasia, and pelvic inflammatory disease. There are studies underway that examine the protective effect of the diaphragm and HIV acquisition, but so far the diaphagm has not been shown more effective than male condoms.
New Diaphragm Technology
Below are some newer diaphragms.
As they are currently being evaluated reliable failure rates are not yet available.
- BufferGel Duet: A disposable, one-size-fits-all, diaphragm made of polyurethane. It is pre-filled with BufferGel, a microbicide and spermicide. Currently under development.
- Semina: A clear, silicone diaphragm with a visible coil spring, available in Brazil.
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